Schizo obessive disorder

1. Schizo-obsessive disorderSchizo-obsessive disorder
? A new subtype of ? A new subtype of
schizophreniaschizophrenia
Dr J RomainDr J Romain
Dr YagoubDr Yagoub

2. Possible definitionPossible definition
Patients who have OCD and Patients who have OCD and
schizophrenia and whose obsessions and schizophrenia and whose obsessions and
compulsions are unrelated to the content compulsions are unrelated to the content
of their psychosis.of their psychosis.

3. Controversy centres on whether there is a Controversy centres on whether there is a
continuum or overlap in psychopathology continuum or overlap in psychopathology
between these entities that some authors between these entities that some authors
have called "schizo-obsessive disorder."have called "schizo-obsessive disorder."

4. Why do we care?Why do we care?
Schizo-obsessive patients have a more Schizo-obsessive patients have a more
chronic course, a greater frequency of chronic course, a greater frequency of
social and occupational impairment, and social and occupational impairment, and
show poor treatment response and a poor show poor treatment response and a poor
long-term outcome. long-term outcome.

5. ResearchResearch
A study by Michael Y. Hwang, M.D in A study by Michael Y. Hwang, M.D in
journal of neuropsychiatry and clinical journal of neuropsychiatry and clinical
neurosciences 12:91-94, Feb 2000neurosciences 12:91-94, Feb 2000
A pilot blind controlled study, 20ptsA pilot blind controlled study, 20pts
Compared characteristics of obsessive-Compared characteristics of obsessive-
compulsive (OC) schizophrenic patients compulsive (OC) schizophrenic patients
and a matched non-OC schizophrenic and a matched non-OC schizophrenic
control group control group

6. Results- Schizo-obessive groupResults- Schizo-obessive group
Significantly longer periods of Significantly longer periods of
hospitalisation hospitalisation
They took more adjunctive medications They took more adjunctive medications
such as benzodiazepines and such as benzodiazepines and
antidepressantsantidepressants
They had a poorer clinical course with They had a poorer clinical course with
lower levels of functioning, especially in lower levels of functioning, especially in
terms of "self-care" and "social terms of "self-care" and "social
competency” competency”

7. Results for Schizo-obsessive groupResults for Schizo-obsessive group
Higher rate of negative symptoms Higher rate of negative symptoms
Higher level of general psychopathology Higher level of general psychopathology
using the Wisconsin Card Sorting Test using the Wisconsin Card Sorting Test
(WCST) and MMSE. (WCST) and MMSE.
No difference in positive symptoms, No difference in positive symptoms,
anergia, depression or thought anergia, depression or thought
disturbance factors.disturbance factors.

8. Summary of StudySummary of Study
Findings indicate that schizo-obsessive Findings indicate that schizo-obsessive
patients may possess a unique clinical patients may possess a unique clinical
and neuropsychological profile within the and neuropsychological profile within the
schizophrenic spectrum schizophrenic spectrum

9. Possible treatment RegimesPossible treatment Regimes
Treatment with serotonin reuptake Treatment with serotonin reuptake
blockers, added to a neuroleptic, is found blockers, added to a neuroleptic, is found
to be efficacious in the treatment of to be efficacious in the treatment of
obsessions and compulsions and to obsessions and compulsions and to
improve overall schizophrenic symptoms. improve overall schizophrenic symptoms.

10. DiscussionDiscussion
Both patients clearly exhibit hoarding as Both patients clearly exhibit hoarding as
their obsessional symptomtheir obsessional symptom
Hoarding is being considered as a part of Hoarding is being considered as a part of
OC spectrum in its own right for DSM-VOC spectrum in its own right for DSM-V
Recent literature suggests that the core Recent literature suggests that the core
symptoms, associated features, and symptoms, associated features, and
neurobiological abnormalities of hoarding neurobiological abnormalities of hoarding
differ from OCD.differ from OCD.

11. Other Possible DiagnosesOther Possible Diagnoses
OC Schizophrenia?OC Schizophrenia?
Compulsive hoarding syndrome with some Compulsive hoarding syndrome with some
psychotic symptoms? psychotic symptoms?

12. Questions?Questions?